Utility of fine needle aspiration cytology to diagnose intraoral tuberculosis and other oral granulomatous lesions

Objective Tuberculosis (TB) is a common granulomatous disease leading to high morbidity and mortality worldwide. Though rare, oral tuberculosis (OTB) may manifest during the primary and/or secondary stages of the illness. We studied the manifestations and incidence of oral granulomatous lesions (OGL) and OTB diagnosed on fine needle aspiration cytology (FNAC). Study design In this retrospective study, we present a review of 149 cases of benign and inflammatory lesions of oral mucosa diagnosed between 2008 and 2016. Result Of the 280 oral FNAC performed during the 9 y study period, 149 cases were diagnosed as benign and inflammatory lesions among which 12 (4.3%) showed granulomatous lesions. Four out of 12 cases were diagnosed as OTB. One (0.011%) was a case of Primary OTB with no associated pulmonary or extrapulmonary manifestations of TB and three had associated lymphadenopathy including one with pulmonary TB. Per the clinical records, all four patients responded well to anti tubercular treatment (ATT) rendered under directly observed treatment short course (DOTS) supervision with regular visits and monitoring. Conclusions Although oral mucosal TB is a rare presentation, clinicians and pathologists need to consider it early in the differential diagnosis of primary and secondary oral mucosal lesions. Such patients should be further evaluated for pulmonary TB and tuberculous lymphadenitis.